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Updated: Jun 22, 2026

Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Endometriotic ovarian cysts negatively affect the rate of spontaneous ovulation
Laura Benaglia1, Edgardo Somigliana, Paolo Vercellini
1Infertility Unit, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via M. Fanti 6, 20122 Milan, Italy. laurabenaglia@hotmail.it
Background:
A growing body of evidence suggests that ovarian reserve is damaged after excision of ovarian endometriomas. However, it may not be excluded that gonadal damage is at least partly caused by the very presence of an endometrioma per se, thus preceding surgery. To clarify this aspect, we set up a prospective study in women with monolateral endometriomas in order to assess the rate of ovulation in affected ovaries.
Materials And Methods:
Seventy women with monolateral endometriomas who had not undergone previous adnexal surgery underwent serial ecographic examinations to determine the side of ovulation.
Results:
Ovulation occurred in the affected ovary in 22 cases (31%; 95% CI: 22-43%). Assuming that the expected rate of ovulation in both ovaries in healthy women is similar, this difference is statistically significant (P = 0.002).
Conclusion:
The physiological mechanisms leading to ovulation are deranged in ovaries with endometriomas.
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